Organization
CORNELIA L AGENT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORNELIA L AGENT MD (OWNER)
(281) 331-5253
Entity
Organization
Contact information
Practice address
215 W BLACKSTONE LN, ALVIN, TX 77511-3407
(281) 331-5253
(281) 585-4074
Mailing address
215 W BLACKSTONE LN, ALVIN, TX 77511-3407
(281) 331-5253
(281) 585-4074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F9123
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114075801
—
TX
Enumeration date
10/03/2011
Last updated
10/03/2011
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